Moving on

Somehow it has taken me six weeks to get back to the writing of this post. I think perhaps that might be indicative of something psychological, don't you? What on earth could possibly be problematic about explaining the injuries that have left me permanently scarred, with a fucked up leg and at present, deep, nasty pains which won't go for months, if not years?

Here's the executive summary:

Deep laceration to left buttock

Bruising, hematoma and raw (no skin) patch above the left knee / around the knee

The biggie part 1) 'degloving' as it is politely termed, below the knee. Skin loss, flesh loss - the works

... leading to part 2, the rebuilt ankle

Right leg from the top! 2 graft sites on the thigh

...and a whopping great scar where I had a skin patch, 'flesh' and what is euphemistically known as a 'working blood vessel' removed in order to rebuild the ankle.

Below the knee, I'd forgotten now, a bunch of bruises on the outside.

Would you like detail? Why certainly.

1. Left buttock

How awkward, to have to wrote the word 'buttock'. While I was on the floor under the lorry, the lovely woman who looked after me said "I have to tell you, I can see some of your fat cells on your bum", at which I asked her not to tell me anything else. I cannot begin to imagine how this happened, but this injury was a deep cut, which was relatively small on the surface. How deep? An inch or two, maybe? I don't know but what I do know is that it caused a lot of hard scar tissue (known as hematoma) which is still there, three months later. It was the injury that everyone forgot about. After all, comparatively boring compared to the groovy plastics challenge of saving my foot. But I would not be lying if I said it's one of my most irritating injuries. It gave me dreadful stitch when I first started walking; if I sit too long in one position, deep bruised hurt flares up.

2. I need to break the above the knee injuries down a little bit.

The red portion shows the deep bruising that's all over the area - as the rest of my leg has become less swollen, it has left a large amount of 'numb' with sort of deep swelling that won't go away (I assume for an absolute age), which surrounds my knee. There's actually a swelling on the outside of the knee, just below, which when it really swells, looks somewhat egg-like.

The grey portion shows the hematoma. Which is horrible, to be frank. It swells out way further than the natural shape of my thigh, it's numb and feels like clay. Heavy. As if someone had inserted a sugar bag sized lump of clay on the inside. Toward the end of the day, gravity starts to pull it down. Hurty, obviously but more than that. Extremely uncomfortable. And it's not going away any time soon.

The 'raw' patch was a skin laceration which was rather odd, in that when I first saw it, it was very heavily bruised skin. Utterly nasty to look at - deep, rich, dark purple blood had inundated the skin. It didn't look much like skin, frankly but that's what I was told. Later, I was told that it was an open patch, which made more sense looking at the visual evidence. It was (and still is) completely numb so it hurt no more or less either way. It did heal, and grow more skin fantastically well over a couple of months and now has a thick scar which is a patch a little bigger than a 50p piece. Like all scars, it will take some years to resolve itself in to its long-term 'look and feel'. At present it looks shiny, lumpy and dark red. Just the way the boys like it.

I felt sick the night before. I felt sick in the morning. I had felt sick in the patient transport driving between the two hospitals which makes some sense being weak but travel sickness? For 12 hours? In reality, I was petrified.

Eight long hours of poison being pumped in to my system. I knew all about long ops, and anaesthetics made me puke, endlessly, for 24 hrs afterwards as a child. That alongside a feeling of ugly brain fug which would only lose its grip the next day. Awful. The truth of the matter is, my having had many anaesthetics has made me hate them ever more vehemently, not inured me against them.

Just before going down in the morning, the plastics team came up to say hello. I have to say they were a formidable bunch. Looking at these sharp faces around the bed, I was struck with the realisation that they were probably together, the best in the country. I felt happy about the op in terms of outcomes. Just the physical action of the anaesthetic made me feel a bit panicky. Somehow, the two debridement ops earlier in the week did not bother me at all. I knew they were short (comparitively), so could not have the heavy, appalling poisoning effects that four or five (or eight) hours would.

The anaesthetist had already introduced himself upstairs. Now we went through the usual rituals of drug taking: confirming name and date of birth. He listened attentively when I explained my reactions and told me that he was going to administer anti-emetics and was also going to make liberal use of a form of nerve numbing using ultrasound. Given that my last heavy ops had completed twenty years before, this was all new to me. From what I can gather, the effect is somewhat epidural-esque. All very interesting but then the anaesthetist told me he was administering a pre-med through one of my cannulas (that's intravenous needle palced in a semi-permanent position in a vein so that drugs and fluids can be administered quickly). I was horrified, "But pre-meds make me si..." before I'd even got to the end of the sentence I knew I had seconds. Luckily they got a bag, and those tiny sips of illicit water came right back up and 'pleasantly' out of the way before being knocked out. He looked slightly bemused but also a little more "Ok, I believe you". Then... knocked out.

...awake. I will never get used to that instantaneous zonked/wake thing. For those who don't know, you don't feel yourself falling to sleep when they drug you, and you wake up apparently super quick thinking "When's the op going to start?"

There I was AWAKE. Feeling like Me, not some half zombie drug addict. My God. Hello? Clear as a bell. Here came a lovely specialist recovery nurse, Louise. How was I feeling? Well... er... fine, to tell you the truth? Obviously on Morphine but... but head completely clear. Amazing. Eight hours... how the hell did they do it? The anaesthetist came to see how I was after a while. I shook his hand and thanked him. He did an *amazing* job.

I couldn't go up to the ward because they needed a specialist nurse who wasn't on until 7.30. So I talked to Louise about the subjects that fascinate me (ie: mostly asking her questions as to why she was a nurse, why she specialised in recovery nursing and then moved on to Life, the Universe and Everything). I knew that wonderful McK was waiting, exhausted and anxious upstairs but still we couldn't go up. Eventually at half past eight, we left. To a bed with all manner of specialist equipment keeping my newly operated on leg warm and my right leg moving, to prevent blood clots. 'Woken' every half an hour for the ward nurse to perform a doppler test to see if my newly reconstructed ankle with its brand new vein, pretending to be an artery from now on (cut out of my right thigh, where presumably I wasn't using it - er, heh) was still doing the blood pumping throb. And It did. All night. And the next day. And the day after.

And so it would seem appropriate to tell you what they actually *did*.

Saturday morning. Straight in to theatre for a good dig around to try and work out what the hell to do, and what was wrong, and right. I am very vague about times except to say that I was back in the ward in the afternoon. Cutting through a ew days and non-essential events, I phoned my boss and friend, Mikey on Saturday afternoon and after I had told him I had gone under a lorry, then laughed down the phone, he said "Are you on morphine?" Mike was the only person who said to mr "Be careful, you'll come down with a crash". Yeah yeah yeah, says I. Aha. He spoke truths.

Another op on Tuesday, and in between, lovely friends to visit. How wonderful that I was able to email my friends and tell them what had happened. Next thing, there's a visiting schedule starting up and I'm just sitting in bed following everything on email and Twitter. For the social media specialists amongst you (and don't you tell me there aren't) it might interest you to know that it didn't even occur to me to jump on to Facebook and announce the crash to an un-edited audience -though I did eventually, once I'd got home.

The Tuesday op was a full on 'debridement'. Let's see what that word might mean, shall we? Extraordinarily gendered, isn't it. It means scraping away all the necrotising skin and flesh. Isn't that nice. And just in case you weren't sure about the word 'necrotising', in short it's the bits that are dead. Going off. Beginning to smell (alright, alright...).

So by now I had met my Plastics consultant, a very nice bloke from St Thomas' called Naveen, who was trying to get me in to have my long operation at St Thomas', where the Plastics ward and specialisation is. He couldn't do Thursday, but there was a possibility of Friday.

The wards at King's were an odd mix of completely new, where the Gynae unit was and I had an utterly splendid room to myself, with a window that opened (unheard of in any hospital) and an aspect that bathed the room in golden hour light in the mornings. From there, I was shuting in to general Obs , which had low ceilings and tiny unopenable windows. The difference in wellbeing was huge. People coming in an preaching with patients, comodes behind flimsy curtains.... agh. There is no room for humility or indeed, personal space, on the ward.

THe people at Kings were fabulous, but tere I was, leaving that tiny hut like ward on Thursday 23rd Jan, on my way to St Thomas' for the longest operation of my life. Operation 'Save the leg'.

I will bring you up to date with the whole story, I promise, but using the blog in a 'diary' function (how novel), I just want to jot down a few "How are you feeling?" notes. None of this will make much sense because I haven't explained the inuries yet, but I mostly started writing this up to give myself an outlet for *moaning like a grumbly old bastard* to be frank. Because there's only so much Twitter-moaning one feels one can subject one's friends to on a daily basis. Not to mention email lists and other friendly outlets.

So. How am I feeling?

Well for the last two days the rebuilt 'flap' ankle has ben hurting like a viper. Why? I have several theories, one of which may be true.

Healing means nerve endings that were numb a week ago are no longer numb

I have an infection

I'm overdoing it and it's complaining

I've had codeine at a 30mg level for nearly three weeks and I've got too used to it

What is it? God knows, but the official dose for Codeine is 30-60mg 'if needed'. Before now, 60 in one go made me go verrrry doolally. So, I thought well, how about taking 30 every couple of hours as opposed to taking a massive dose every 4? I've been suffering slightly from the peaks and troughs of pain relief cycles so, a more constant stream of the lower dose? Seems to make a difference. A bit.

Shattered though. An afternoon of pain. Still. The District Nurses came earlier on and I noticed when the main nurse was wiping down a particular bit of 'the injury', the feeling of numbness was very slightly reduced. I've been in the position of feeling nothing on the open surface, but I could feel pressure from about a centimetre and a half in. Really odd. That sensation was far closer to the surface. So. potentially good news. Who can tell. About the only thing I can tell is that this is going to take a long, long time.

The paramedics had been on the scene for... well, an amount of time which was not short. It's very difficult to have a full grip on reality when you're experiencing the 'now' through several filters. Extreme pain and morphine, not to mention varying degrees of raging hormones.

I'd fogotten, yesterday that there was a point, after the paramedics arrived when I talked about my kids - they were keeping me talking, for obvious reasons. And for the first time, I cried. I cried because of the effect this would have on them. That I wasn't going to be putting them to bed and snuggling up for a night time kiss, and what it would have meant to them if I was dead right now. And, my 'watching this all from above' objective self told me that the adrenalin might be wearing off a bit, leaving a giant emotional hole in its wake, waiting to be filled with tears.

...but no time for weeping and wailing. Off I went to hospital and was deposited straight in to their 'most urgent' setting, at Kings College Hospital in Camberwell. I had time to look at the Paramedic who had been looking after me and told her "You were awesome". Because I'm an internet citizen, of course, the A word must be used. And she was, she really was. I have a mind to drop off some Christmas chocolates to the Paramedics at Kings every year from now on.

The Docs took the neck brace off thank god and then a most peculiar and eyebrow raising event occurred. A lady leaned over me to talk:

"Hello, Cait? Channel 4 are filming the A&E at the moment and I just wanted to know if it's alright if they film you"

"Uh? What? Er... yeah, whatever". Remember, this is morphine talking.

So this is what was happening. Channel 4 at present produce a show called "24 Hrs in A&E" which is filmed at Kings. They are - or were, in February, filming the new series. After the Doc who had asked my permission left, I noticed that there were cameras embedded in the ceiling, on the sides, you name it. Shortly afterwards, a bloke appeared, looking like 'practical I work in media' (ie: cameraman type) and put a variant of a tie-mic on the cabinet next to my pillow! It was Insane. I was told I could withdraw my permission afterwards and the TV people shrank in to the background.

I've been on TV, just by way of context for this bizarre occurrence, *far too much* for someone who does not have a career in television (or want one). Quiz shows as a kid, Top of the Pops when my Dad worked there, Sky News Internet Expert (woohoo) back in the days when I had blonde hair and was a size 12. I even appeared on ITV News at 10 reading out the court judgement which had arrived by internet on whether Louise Woodward was inocent or guilty. Not by choice, I might add. So, I tend to walk in the other direction when I see cameras. They have a nasty habit of picking me out in crowds. And here we are, with the inside of my body being revealed to the Ch4 audience. Bizarre, but also in my case, one of those 'fate' like coincidences that happens a little bit too often.

And Mackay! Mackay came. He was there. My God I needed him. Well, actually, by then I was so doped out of my mind I was chatting away merrily to anyone who would listen. But him being there meant things felt more solid. I heard the Policeman on the phone saying precious words: "Non-life-threatening, Non-life-transforming" to the station, or local press, or... someone. Meanwhile, the A&E guys had a quick look at my leg to try and tart it up a bit. I had not looked and would not look. Poor Mackay had to look because it was... there, really. At a point, they lifted a paperish dressing thingy off my ankle and I saw Mackay go green and utter tranditional minor swear words at whatever lay undereneath. I was slightly more concerned by the point that it HURT LIKE A BUGGER to even lift a tiny piece of paper off my leg. I asked him to take a photograph, because I thought, in six months time I might be able to look at it, through my fingers.

At various points, McK and I were left alone for a few moments and we talked. I have a feeling that I sounded fairly normal, because the morphine was so hefty but of course, I have yet to see the Ch4 footage. I may be laughing my head off half the time. Who knows. I will give an update to this section when the programme is on. They told me they'd send me all the footage on DVD beforehand. I'll believe it when it happens.

They put a temporary plaster of paris cast on the leg with some sort of splint type bit at the bottom, holding my foot in place because as it turned out, there was a hole by my ankle that was deep, and apparently made my bones visible. Hence Mackay went green.

Operation in the morning so they could assess what the hell was salvageable, meanwhile I was packed off to a spare bed - Women's Gynae, would you believe. Mackay left (and it turned out, took several hours to get home because the doors to the hospital were locked) and I crashed in to sleep.

So there I am, lying under a lorry, with my leg having been dragged along the road by a braking tyre, with said tyre on top of said leg. And I'm not dead. And My God, it hurts. I've never felt anything like this in my life. I've had two kids, braying like a donkey in agony and I've never felt pain like this. And I'm awake.

"HELP ME! HELP ME!" I'm screaming out. Pretty pointlessly really, obviously but partially I think I was thinking that I need to let them know I'm not dead. People's legs start appearing. I don't move because hey, I've watched Casualty and ER. Best thing to do is not to move, right? A woman appears to be crying somewhere to the right. Thank you for that but good god get that lorry OFF MY LEG. I can't quite describe what the pain was like. Three different elements going on. 1) My leg is injured at multiple points 2) My body has decided to release VAST tranches of adrenalin, which presently are causing my whole leg to go in to cramp. Thank you so much, body! Stop this now! And third. The lorry. My God. Sorry, I keep envoking a non-existent deity here but it's a traditional way to express the inexpressible. I mean it's not the whole weight of the lorry, just the amount that's channeled through one set of its wheels.

That's a lot of weight.

"GET IT OFF MY LEG!" I'm screaming. I don't really scream very often. I apparently scream pretty loudly. After an amount of time (I have no idea) the lorry driver reversed, pretty slowly ie: carefully, off my leg. Please note, I am merely stating what happened here, I make no comment positively or negatively. Christ, that felt better. In fact, that was pretty stupid of me, medically speaking. All kinds of crap could have happened as a result of releasing the pressure on the leg, so, if you're ever in that position, please don't remember what happened to me and imagine it's a good idea. But it felt better. BETTER.

I couldn't feel my leg to move it. I thought it was gone, frankly. There was a really odd pain on my knee which was like it had been mashed up, and weirdly, squished in to the floor like someone was standing on top of it. I could sense blood all over the place. I don't really know if it was. Oh yes, Mr Adrenalin bloody gland. I thought the general idea was that you were supposed to be pumping me with so much adrenalin that I felt no pain? LIAR!

Then a woman came along and looked after me. She was called Denise and I LOVE THAT WOMAN. Thank you, Denise, you are beautiful. You deserve every good thing. Seriously, I send you flowers from my heart on a daily basis and if I could give you a luxury break in Italy I would. All women (or men) who do what Denise did need huge rewards. I'll tell you what she did. She dropped everything, she held my hand and she told me what was going on. She gently took the piss out of me being so shouty to keep me talking. She started explaining what injuries she could see ("I can see some fat cells on your bum I'm afraid" Me: "Don't want to know! Don't want to know anything you can see".)

I'm going ahead of myself slightly. Denise arrived as I was doing the following. Yelling my family's home phone number out over and over because I feared I was going to lose consciousness and my lovely husband wouldn't know what the hell was going on. It was Denise who rang the number. Unfortunately, it was at the time of night when, if I'm going to be late home, I phone to say godnight and I'll see you when you're in bed, to the kids. So Nora answered the phone.

"Is your Daddy there?" I almost thought it was funny. In an "Oh no" kind of way. I attempted to shut my trap and not be yelling in pain in the background. Then I could hear that McK was on the phone. The "She's ok" phrase was envoked. Apparently he could hear me in the background. What was I doing? Moaning? Shouting? God knows.

Then after an unknown amount of time, the paramedics arrived. Halleluyah. "Give me morphine, please" were the first words that came from my mouth to the BRILLIANT paramedic who took over from Denise in the handholding stakes. they couldn't give it to me straight away for some reason so I had to have gas and air! Which made me inwardly amused, in a way. I bit the mouthpiece as if I was going to bite through the damn thing and sucked that horrible crap in to my lungs. To be honest, it didn't make a lot of difference. The other paramedics started cutting off my grey trackie bottoms. I don't think they were grey anymore.

"Here, look, I can move the other leg" I said, waggling my right leg around. And then, astonishingly, I found that I could move my big toe on my left leg. Oh Wow. They had cut through the laces, taken off my shoes and cut off the socks (sorry I was wearing two pairs. They were thin). There was my toe, on my apparently 'gone' leg - moving! The morphine arrived, in injection form. First lot made no difference that I could feel. So I had some more. the max amount I could have. To tell you the truth, it still hurt, a hell of alot.

We were going to be on the move. I suddenly had that addict's need to know that my phone was alright. I could see my bike, which looked... bizarrely still bike-ish and not a mangled wreck. "My phone! It's in the back pocket, behind the saddle". Someone, bless them, grabbed my helmet and shoved the (still working!) phone, my keys and the oyster card holder from my bike's bum-bag in to the shell of it. The Police must have taken it with them in the ambulance. I can't remember what I said about the panniers but of course, I was worried about my Air, I mean f'gad's sake! Priorities!

"Cait, we're going to have to put this collar on"

"There's nothing wrong with my neck" I explained. But it's protocol, just in case. And let me tell you, those neck braces are extremely uncomfortable. They had to get me on a stretcher. I knew it would be bad. It was. The paramedics put some kind of covering over part of my leg. I nearly hit the roof. And then, bang, we're in the Ambulance.

The only thing I remember about the ambulance was the coppers. Two lovely guys. They asked me basic questions and they talked to McK on the phone to let him know where we were going. By this point, the morphine had made me alot more comfortable. It's odd stuff. I could still feel the pain, but I could rise above it. Felt reasonably happy. I thought about how lovely the two Policemen were being. Sincerely decent, and the brilliant, clear, supportive wonder of the paramedics. This wasn't morphine talking. This was the truth. We are so lucky to be paying for people who don't just do the job, get their training and get paid. These folk were decent, lovely people. I had a little moment of being proud to be paying taxes.

I'm not quite sure what I should say about the crash, and the circumstances of it, because we have engaged with solicitors and I am VERY VERY ANGRY and I HURT. A LOT. So here's a sort of 'sanitised' version, I suppose.

The location was just past the railway bridge cycling in to South London along the blue cycle highway on Southwark Bridge Road. It involved a lorry, and I was cycling in the...er... blue cycle superhighway. So. that's it for detail.

Hello! I'm waving wildly because I'm about to embark on the most activity this blog has seen in *donkeys*. And I'm soooo pleased to announce it was because I was nearly killed. On Feb 17th, coming home from work.

THere's a hell of alot in this to write about, obviously. The most important thing to say to you is that I wasn't, of course. And that in the long term, my injuries are so much more limited than they could be that, well it's easy for me to frame statements as if I'm downplaying them, whereas in fact of course, it's all pretty astonishingly nasty and very hurty. So, what I'm going to do is try to break it down in to lots of hopefully not too long entries. With diagrams! But no gore I'm afraid. If *I* am having problems looking at the internal workings of my left leg, I think that level of literal intrusion can stay private. When it's better, perhaps.

So, sit back, relax, and enjoy the somewhat Not Good story of the night I nearly died, and what is happening next....